Healthcare Provider Details

I. General information

NPI: 1558673335
Provider Name (Legal Business Name): TRACY M FRANK MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 CALIFORNIA DR
VACAVILLE CA
95687-6643
US

IV. Provider business mailing address

1707 CALIFORNIA DR
VACAVILLE CA
95687-6643
US

V. Phone/Fax

Practice location:
  • Phone: 707-294-3161
  • Fax:
Mailing address:
  • Phone: 707-294-3161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12040854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: